EPCAM Gene Mutations (Lynch Syndrome)

What is an EPCAM mutation?

EPCAM is a gene that helps repair damage to your DNA. Inherited mutations in the EPCAM gene cause Lynch syndrome. People with Lynch syndrome have an increased risk for several types of cancer. Other names for Lynch syndrome include:

• Hereditary Nonpolyposis Colorectal Cancer (HNPCC)
• Muir-Torre syndrome, which refers to a subset of Lynch syndrome in which people have an increased risk of developing rare skin tumors.

Mutations in EPCAM cause Lynch syndrome by affecting a nearby gene called MSH2, which is also linked to Lynch syndrome. Cancer risks and risk-management recommendations are similar for people with mutations in EPCAM or MSH2. 

Which cancers are associated with an EPCAM mutation?

People with an inherited EPCAM mutation have an increased risk for many cancers, especially of the large intestine (the colon and the rectum) and uterus (endometrium). Expert guidelines include estimates of the lifetime cancer risks for people with EPCAM mutations. These are updated yearly based on new research. 

Does everyone with an EPCAM mutation develop cancer?

Although the lifetime risk for cancer with an EPCAM mutation is very high, not everyone with the mutation develops cancer. Following the guidelines for screening and prevention increases the chances of preventing cancer or catching it at its earliest and most treatable stage.

Can EPCAM mutations skip a generation?

EPCAM mutations are passed down from parents to children, but they do not skip generations. Each person with an EPCAM mutation has a 50% chance of passing their mutation on to each of their children. Children who did not inherit their parent's EPCAM mutation cannot pass the mutation to their children. 

People with an EPCAM mutation who never develop cancer can still pass their mutation on to their children. A child who inherits their parent's EPCAM mutation will be at increased risk for cancer. 

What can people with an EPCAM mutation do?

People with an EPCAM mutation have options for screening, prevention and treatment of hereditary cancer. There are expert guidelines and clinical trials that focus on:

• screening and early detection
• risk-reduction
• treatment 

There may be other medical concerns, including a rare childhood disease known as “constitutional mismatch repair deficiency (CMMRD),” which can happen in people who inherit a mutation in both copies of their EPCAM gene. 

If you test positive for an EPCAM mutation, you should inform your close blood relatives (first-, second-, and third-degree relatives) about your test results and encourage them to speak with a genetics expert.